Prevalencia de conductos en C de segundos molares mandibulares evaluados en tomografía de haz cónico / Prevalence of C-ducts of Mandibular Second Molars Evaluated on Cone Beam Tomography

Introducción: El conocimiento adecuado de la configuración de conductos radiculares es fundamental en endodoncia; la evaluación tomográfica permite una correcta evaluación de su disposición radicular. Objetivo: Determinar la prevalencia de conductos en C de segundos molares mandibulares, evaluados en tomografía de haz cónico. Métodos: Se realizó un estudio descriptivo y de corte transversal; la muestra estuvo conformada por 200 segundos molares mandibulares permanentes de una población peruana, observadas en tomografías cone beam, donde se registró la presencia del conducto en C, su configuración según la clasificación de Fan y el sexo del paciente. Resultados: La prevalencia de la configuración radicular en forma de C en segundos molares inferiores fue del 65,5 por ciento; según la Clasificación de Fan se observó mayor prevalencia en el tercio cervical del conducto radicular el tipo C1 con 85,7 por ciento; en el tercio medio el tipo C2 con 42,9 por ciento; a nivel apical fue el tipo C3C con 72,1 por ciento; según el sexo, el 65,2 por ciento de los conductos en C correspondió al femenino. Conclusión: La prevalencia de los conductos en C de los segundos molares mandibulares evaluados en tomografías de haz cónico fue de 65,5 por ciento con mayor predominio en el sexo femenino. La evaluación tomográfica permite una mejor identificación y configuración interna de los conductos radiculares(AU)

Introduction: Adequate knowledge of the configuration of root canals is fundamental in endodontics; tomographic evaluation allows a correct assessment of their radicular arrangement. Objective: To determine the prevalence of C-shaped canals in mandibular second molars, evaluated by cone beam tomography. Methods: A descriptive and cross-sectional study was carried out; the sample consisted of 200 permanent mandibular second molars from a Peruvian population, observed in cone beam tomography, where the presence of the C-shaped canal, its configuration according to Fan's classification and the patient's gender were recorded. Results: The prevalence of the C-shaped root canal configuration in lower second molars was 65.5 percent; according to the Fan classification, the highest prevalence was observed in the cervical third of the root canal, type C1 with 85.7 percent; in the middle third, type C2 with 42.9 percent; at the apical level it was type C3C with 72.1 percent; according to gender, 65.2 percent of the C-shaped canals corresponded to females. Conclusion: The prevalence of C-shaped canals in mandibular second molars evaluated in cone beam tomography was 65.5% with a higher predominance in the female gender. The tomographic evaluation allows a better identification and internal configuration of the root canals(AU)

Acquired epidermolysis bullosa in a pediatric patient.

BACKGROUND: Acquired epidermolysis bullosa is a rare and chronic autoimmune subepidermal bullous disease characterized by the formation of autoantibodies against type VII collagen. Presentation in childhood is rare and with several manifestations. CASE REPORT: We report the case of a 12-year-old female patient who presented bullous and polymorphic lesions on the chest and extremities of several months of evolution. Due to the characteristics of the skin lesions, a histopathological and direct immunofluorescence study was conducted, confirming the diagnosis of acquired epidermolysis bullosa. Subsequently, corticosteroid and dapsone treatment was administered, with favorable clinical response during follow-up. CONCLUSIONS: Acquired epidermolysis bullosa is unusual in pediatric age, so it should be considered in the differential diagnosis of other congenital and acquired bullous diseases of childhood. The definitive diagnosis is performed through an immunofluorescence, study, which allows for rapid and effective treatment to control the disease and avoid permanent sequelae.

INTRODUCCIÓN: La epidermólisis bullosa adquirida es una enfermedad ampollar subepidérmica autoinmune, rara y crónica caracterizada por la formación de autoanticuerpos contra colágeno tipo VII. La presentación en la infancia es poco frecuente y con manifestaciones variables. CASO CLÍNICO: Se describe el caso de una paciente de sexo femenino de 12 años de edad que presentó lesiones ampollares y polimórficas en tórax y extremidades de varios meses de evolución. Por las características de las lesiones cutáneas, se realizó un estudio histopatológico y de inmunofluorescencia directa que confirmó el diagnóstico de epidermólisis bullosa adquirida, por lo que se administró tratamiento con corticoide y dapsona, con una respuesta clínica favorable durante el seguimiento. CONCLUSIONES: La epidermólisis bullosa adquirida es inusual en la edad pediátrica. Por tanto, debe considerarse en el diagnóstico diferencial de otras enfermedades ampollares congénitas y adquiridas de la infancia. El diagnóstico definitivo se realiza a través del estudio de inmunofluorescencia, lo que permite instaurar rápidamente un tratamiento rápido y eficaz para controlar la enfermedad y evitar secuelas permanentes.

Epidermólisis bullosa adquirida en un paciente pediátrico / Acquired epidermolysis bullosa in a pediatric patient

Resumen Introducción: La epidermólisis bullosa adquirida es una enfermedad ampollar subepidérmica autoinmune, rara y crónica caracterizada por la formación de autoanticuerpos contra colágeno tipo VII. La presentación en la infancia es poco frecuente y con manifestaciones variables. Caso clínico: Se describe el caso de una paciente de sexo femenino de 12 años de edad que presentó lesiones ampollares y polimórficas en tórax y extremidades de varios meses de evolución. Por las características de las lesiones cutáneas, se realizó un estudio histopatológico y de inmunofluorescencia directa que confirmó el diagnóstico de epidermólisis bullosa adquirida, por lo que se administró tratamiento con corticoide y dapsona, con una respuesta clínica favorable durante el seguimiento. Conclusiones: La epidermólisis bullosa adquirida es inusual en la edad pediátrica. Por tanto, debe considerarse en el diagnóstico diferencial de otras enfermedades ampollares congénitas y adquiridas de la infancia. El diagnóstico definitivo se realiza a través del estudio de inmunofluorescencia, lo que permite instaurar rápidamente un tratamiento rápido y eficaz para controlar la enfermedad y evitar secuelas permanentes.

Abstract Background: Acquired epidermolysis bullosa is a rare and chronic autoimmune subepidermal bullous disease characterized by the formation of autoantibodies against type VII collagen. Presentation in childhood is rare and with several manifestations. Case report: We report the case of a 12-year-old female patient who presented bullous and polymorphic lesions on the chest and extremities of several months of evolution. Due to the characteristics of the skin lesions, a histopathological and direct immunofluorescence study was conducted, confirming the diagnosis of acquired epidermolysis bullosa. Subsequently, corticosteroid and dapsone treatment was administered, with favorable clinical response during follow-up. Conclusions: Acquired epidermolysis bullosa is unusual in pediatric age, so it should be considered in the differential diagnosis of other congenital and acquired bullous diseases of childhood. The definitive diagnosis is performed through an immunofluorescence, study, which allows for rapid and effective treatment to control the disease and avoid permanent sequelae.

Effect of breathing type on electromyographic activity of respiratory muscles during tooth clenching at different decubitus positions.

OBJECTIVE: To compare the effect of breathing type on electromyographic (EMG) activity of respiratory muscles during tooth clenching at different decubitus positions. METHODS: Forty young men participants were included, 11 with upper costal, 9 with mixed, and 20 with costo-diaphragmatic breathing type. EMG recordings of diaphragm (DIA), external intercostal (EIC), sternocleidomastoid (SCM), and latissimus dorsi (LAT) muscles during tooth clenching in the intercuspal position were performed in dorsal, left lateral, and ventral decubitus positions. RESULTS: DIA EMG activity was higher in subjects with upper costal or mixed than with costodiaphragmatic breathing type (p = 0.006; 0.021, respectively), whereas it was similar between upper costal and mixed breathing types. EIC, SCM, and LAT activity was similar among breathing types. CONCLUSION: Higher DIA activity would be a risk factor to exceed the adaptive capability of healthy subjects with upper costal or mixed breathing type.

Effects of breathing type on electromyographic activity of respiratory muscles at different body positions.

AIM: To compare the effect of breathing type on the activity of respiratory muscles at different body positions. METHODOLOGY: Two groups of 20 subjects each, one with upper costal and the other with costodiaphragmatic breathing, were studied. Electromyographic activity of sternocleidomastoid (SCM), diaphragm (DIA), external intercostal (EIC), and latissimus dorsi (LAT) muscles was recorded at standing and lateral decubitus positions during swallowing and maximal voluntary clenching. RESULTS: All muscles showed higher activity during standing in upper costal breathing subjects except the SCM muscle. EIC activity was higher during standing in the costodiaphragmatic breathing group. Subjects with upper costal breathing showed higher DIA activity than subjects with costodiaphragmatic breathing at both body positions and higher SCM activity at lateral decubitus position, whereas, EIC activity was only higher during swallowing. CONCLUSIONS: Subjects with upper costal breathing presented higher respiratory effort than subjects with costodiaphragmatic breathing, being most prominent at the lateral decubitus position.

Comparison of muscle activity between subjects with or without lip competence: Electromyographic activity of lips, supra- and infrahyoid muscles.

AIM: This study compares the electromyographic (EMG) activity of the muscles from the lips and hyoid bone in subjects with or without lip competence. METHODOLOGY: Two groups of 20 subjects each, with or without lip competence were studied. EMG activity of the superior orbicularis oris (SOO), inferior orbicularis oris (IOO), suprahyoid (SH) and infrahyoid (IH) muscles was recorded with the subject seated in the upright position during the following tasks: (1) at rest; (2) speaking; (3) swallowing; (4) forced deep breathing; (5) maximal voluntary clenching; and (6) chewing. RESULTS: EMG activity was significantly higher in subjects without competent lips than with competent lips in the SOO and IOO muscles during tasks 3 and 4, SOO during task 2 and IOO during task 6. EMG activity was similar in the SOO and IOO muscles during tasks 1 and 5, SOO during task 6 and IOO during task 2. Activity of the SH and IH muscles was similar in both groups for all tasks. CONCLUSIONS: Higher activity in subjects without competent lips implies a higher muscular effort due to the requirement of lip sealing during functional activities. Hyoid muscular activity was not modified by the presence or absence of lip competence.

Effect of upper costal and costo-diaphragmatic breathing types on electromyographic activity of respiratory muscles.

AIM: To compare electromyographic (EMG) activity in young-adult subjects with different breathing types. METHODOLOGY: This study included 50 healthy male subjects with complete natural dentition, and no history of orofacial pain or craniomandibular-cervical-spinal disorders. Subjects were classified into two groups: upper costal breathing type, and costo-diaphragmatic breathing. Bipolar surface electrodes were located on sternocleidomastoid, diaphragm, external intercostal, and latissimus dorsi muscles. Electromyographic activity was recorded during the following tasks: (1) normal quiet breathing; (2) speaking the word 'Mississippi'; (3) swallowing saliva; and (4) forced deep breathing. RESULTS: Sternocleidomastoid and latissimus dorsi EMG activity was not significantly different between breathing types, whereas diaphragm and external intercostal EMG activity was significantly higher in the upper costal than costo-diaphragmatic breathing type in all tasks (P<0·05; Wilcoxon signed rank-sum test). CONCLUSION: Diaphragm and external intercostal EMG activity suggests that there could be differences in motor unit recruitment strategies depending on the breathing type.

The effect of a mandibular advancement appliance on cervical lordosis in patients with TMD and cervical pain.

AIMS: A preliminary study to compare cervical lordosis by means of cervical cephalometric analysis, before and after six months of continuous mandibular advancement appliance (MAA) use, and to show how physical therapy posture re-education would improve the cervical lordosis angle. METHODOLOGY: Twenty-two female patients with temporomandibular disorders (TMD) and cervical pain with lordosis <20° were included. Patients had to have a muscle pain history for at least six months, and with an intensity ⩾6, measured by means of a visual analog scale (a horizontal 0-10 numeric rating scale with 0 labeled as 'no pain' and 10 as 'worst imaginable pain'). Patients had to present the angle formed by the posterior tangents to C2 and C7 of equal or less than 20°. Cephalometric and clinical diagnostics were performed initially (baseline) and at the end of the study period (six months). During the third month with MAA treatment, a physical therapist evaluated the postural deficit and performed a program of postural re-education. Angular and linear dimension data presented a normal distribution (P>0·05; Shapiro Wilk Test), so the paired comparison of the cephalometric measurements was made by t-test for dependent samples. RESULTS: Angle 1 (OPT/7CVT); angle 3 (CVT/EVT) and angle 4 (2CL/7CL) showed a significant increase in the cervical lordosis. Angle 2 (MGP/OP), angle 5 (HOR/CVT) and the distances C0-C2 and Pt-VER, presented no significant changes. CONCLUSIONS: The increase in cervical lordosis implies that six months of continuous MAA use, together with a program of postural re-education, promotes the homeostasis of the craniocervical system.

Remediation of phenol-contaminated soil by a bacterial consortium and Acinetobacter calcoaceticus isolated from an industrial wastewater treatment plant.

Time-course performance of a phenol-degrading indigenous bacterial consortium, and of Acinetobacter calcoaceticus var. anitratus, isolated from an industrial coal wastewater treatment plant was evaluated. This bacterial consortium was able to survive in the presence of phenol concentrations as high as 1200mgL(-1) and the consortium was more fast in degrading phenol than a pure culture of the A. calcoaceticus strain. In a batch system, 86% of phenol biodegradation occurred in around 30h at pH 6.0, while at pH 3.0, 95.2% of phenol biodegradation occurred in 8h. A high phenol biodegradation (above 95%) by the mixed culture in a bioreactor was obtained in both continuous and batch systems, but when test was carried out in coke gasification wastewater, no biodegradation was observed after 10 days at pH 9-11 for both pure strain or the isolated consortium. An activated sludge with the same bacterial consortium characterized above was mixed with a textile sludge-contaminated soil with a phenol concentration of 19.48mgkg(-1). After 20 days of bioaugmentation, the remanescent phenol concentration of the sludge-soil matrix was 1.13mgkg(-1).

L-propionyl-carnitine protects tissues from ischaemic injury in an 'in vivo' human ischaemia-reperfusion model.

OBJECTIVE: To assess the acute effects of L-propionyl-carnitine (LPC) on vaso-motion, tissue perfusion and tissue acidosis during an ischaemia-reperfusion test in patients with intermittent claudication. DESIGN: Open pharmacodynamic study. STUDY PARTICIPANTS: Sixteen male patients with intermittent claudication (mean absolute claudication distance 193.19 ± 51.51m). INTERVENTIONS: Intravenous infusion of LPC 600mg. MAIN OUTCOME MEASURES AND RESULTS: Laser-Doppler perfusion units and power spectrum, transcutaneous oxygen pressure (TcPO(2)) and transcutaneous carbon dioxide pressure (TcPCO(2)) were measured at baseline, during ischaemia (which was induced by means of an inflated pneumatic cuff wrapped around the calf) and during reperfusion, before and after LPC infusion. Perfusion units and TcPO(2) did not change significantly after LPC infusion compared with pretreatment values. Conversely, mean laser-Doppler power spectrum, which was 0.20 units at rest and 1.13 during reperfusion before treatment, increased significantly to 0.89 and 2.24, respectively, after LPC infusion (p = 0.01 and p = 0.00074, respectively, vs pretreatment values). LPC had no significant effects on resting TcPCO(2), but induced a significant decrease in TcPCO(2) measured at hypoxia point (96.9mm Hg before treatmentvs 90.2mm Hg after treatment; p = 0.001) and during reperfusion (115.9vs 103.5mm Hg, respectively; p = 0.0006). CONCLUSIONS: These results show that LPC protects tissues from ischaemic injury by improving arteriolar function and reducing acidosis, without affecting arterial inflow. This may explain the beneficial effects of LPC in patients with intermittent claudication and suggests a potential use of this drug in other stages of peripheral arterial disease and in patients undergoing surgery.

Toxicity-based criteria for the evaluation of textile wastewater treatment efficiency.

Brazilian textile mills import wastewater treatment technologies, performances of which are generally evaluated only on a physicochemical basis. Thus, a battery of bioassays was used to evaluate the performance of an ozonation system to treat textile effluents. Comparative toxicological profiles for bacteria (Vibrio fischeri), algae (Scenedesmus subspicatus), daphnia (Daphnia magna), fish (Poecilia reticulata), and plants (soybean--Glycine max, rice--Oryza sativa, and wheat--Triticum aestivum), as well as genotoxic effects (Vicia faba micronucleus assay), are presented for both raw and ozonated textile effluents. The relative sensitivity of bioassays (or end points) to textile effluents found in this study in decreasing order was plant enzymes > bacteria > algae daphnids approximately = plant biomass approximately = germination rate > fish. No significant genotoxic effect was found. We have concluded that ozonation was relatively effective in reducing toxicity of textile effluents. Bioassays used in this study proved to be sensitive and reliable tools for determining the toxicity of industrial effluents, and thus they can be used to evaluate emerging technology efficiency.

Estudio clínico, bioquímico y terapéutico de la secreción incrementada de somatropina / Clinical, bioclinical and therapeutical study of somatotropine hypersecretion

Se ha estudiado a 172 pacientes, 165 diagnosticados de acromegalia y 5 de gigantismo, atendidos entre 1962 y 1994, mediante evaluaciones clínicas, determinaciones de somatotropina (STH), exámenes por imágenes, exámenes oftalmológicos y cardiovasculares, así como el tratamiento administrado. La hipersecreción de STH fue de 33 veces más frecuente en adultos (acromegalia) que en jóvenes (gigantismo). Acromegalia: El diagnóstico fue clínico en 53 casos y en 112 se efectuó además mediciones de STH. La acromegalia fue más frecuente en el sexo masculino (54.5 por ciento) que en el femenino (45.4 por ciento), con una edad promedio de 43.5 años (rango 20-28 años). El índice de masa corporal (IMC) estuvo por encima de lo normal en el 71.4 por ciento de casos. El 46.4 por ciento nació en la costa, 45.0 por ciento en la sierra 8.03 por ciento en la selva; procedían de la costa 85 por ciento, de la sierra 11.6 por ciento y de la selva 2.67 por ciento. En 88.2 por ciento de los acromegálicos no tratados, la acromegalia estuvo en actividad y se encontró 11.8 por ciento de acromegalias frustras (inactivas espontáneamente). En el 50 por ciento de pacientes sometidos a hipofisectomía y 45.4 por ciento irradiados antes de la primera consulta, la acromegalia aún permanecía activa. En 15.95 por ciento se encontró curvas diabéticas de glicemia y en 11.7 por ciento adicional existía intolerancia a la glucosa. Se encontró hiperprolactinemia en el 50 por ciento de acromegálicos, las concentraciones de prolactina (PRL) fluctuaron entre 6 a 1000 ng/ml (promedio 127.8 ng/ml). En 57/68 acromegálicos las radiografías simples de cráneo demostraron la existencia de macroadenomas, en 2 microadenomas y en 9 fueron normales. En 20 tomografías axiales computarizadas (TAC) se encontró 13 macroadenomas con expansión extrasellar, 1 macroadenoma circunscrito a la hipófisis, 5 microadenomas y, en 1 caso, la silla turca incrementada de volumen no contenía adenomas. En 38.5 por ciento de pacientes se encontró compromiso de las vías ópticas consistente en hemianopsia bitemporal (16.6 por ciento), reducción concéntrica de los campos visuales (6.41 por ciento), cuadrantopsias (3.84 por ciento) y en 5.12 por ciento hemianopsias unilaterales. Se ha encontrado hipertensión arterial en el 17.5 por ciento y otras alteraciones cardiovasculares en el 19.4 por ciento...